Surgical resection is the most efficient therapy for lung cancer. Preoperative investigation should determine histology, local invasion and distant dissemination. Tumor-host relation (immunocompetence and tumor burden) is essential for long-term results. Relatively crude anatomical staging does not take biological parameters into account, and any case with lympho-glandular involvement (N1) should not be considered as stage I carcinoma. 520 cases treated by pulmonary resection are reviewed and common denominators for long-term survivors determined. Stage I epidermoid carcinoma treated by lobectomy or left pneumonectomy with a short history (survey cases) are the ideal candidates for surgical resection. The importance of early diagnosis by routine screening is stressed.